Individual
CHELSEA LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3999 HIGHWAY PP, POPLAR BLUFF, MO 63901-9110
(573) 712-2280
Mailing address
PO BOX 3, POPLAR BLUFF, MO 63902-0003
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
12/20/2023
Last updated
12/20/2023
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